Mosquitoes and Rabies Lecture

Question 1

• Uniformly fatal viral encephalitis of mammals
• Transmitted by saliva of infected animals

*While most mammals can be infected, only a few species serve as reservoir hosts

Answer 1

Rabies

Question 2

virus lives in saliva, brain, spinal cord of infected animals
*Spread when infected animals bite or scratch animal/human

**NOT spread by petting rabid animal, contacting dried saliva, blood, urine, or feces from rabid animal

Answer 2

Rabies

Question 3

What animal is the principal vector for human rabies cases in the US

Answer 3

Bats

Question 4

Overt signs of rabies will always develop within ___ days of presence of virus in saliva

Answer 4

10

Question 5

Incubation period of human rabies

Answer 5

4-12 weeks

Question 6

Prodrome (2-10 days): paresthesias at site of wound, nonspecific constitutional illness (fever, headache, anorexia)

Answer 6

Rabies

Question 7

Acute Neurologic Phase (2-7 days): Signs of encephalitis (mental status changes, paresis and paralysis, hyperactivity, aphasia), hypersalivation, myoclonus, agitation/anxiety.

Answer 7

Rabies

Question 8

What stage of rabies consists of: coma, dysrhythmias, DIC, death

Answer 8

Late stage

Question 9

How many documented cases of human rabies survival are there? (all had some pre or post exposure vaccination)

Answer 9

6!

Question 10

Decrease exposures to potentially rabid animals

Pre-exposure vaccination for high-risk

Post-exposure immunization with vaccine and immune globulin (HRIG)

Answer 10

Ways to prevent human rabies

Question 11

Human Diploid Cell Vaccine (HDCV)

Purified Chick Embryo Vaccine (PCEC)

Rabies Vaccine Adsorbed (RVA)

Answer 11

Cell culture vaccines for rabies

Question 12

Local reactions
Mild systemic reactions
Anaphylaxis (rare!)
Serum sickness-like

Answer 12

Adverse reactions associated w rabies vaccines

Question 13

Passive temporary protection (immediate)

Derived from human plasma

Heat and chemical inactivation

Anaphylaxis and significant adverse effects are rare

Answer 13

Human Rabies Immune Globulin (HRIG)

Question 14

Persons bitten by animal known to be rabid

Persons bitten by an animal likely to be rabid but unavailable for testing

Persons bitten by a raccoon, skunk, fox, bat or other carnivore that cannot be tested

Certain other “nonbite” exposures

Answer 14

Need PEP (post exposure for rabies)

Question 15

• cleansing and irrigation of wound
• vaccine (IM deltoid) on days 0,3 7, 14
• HRIG infiltrated in and around wound

Answer 15

Protocol for those exposed to rabies IF NOT PREVIOUSLY VACCINATED

Question 16

Cleansing and irrigation of wound

Vaccine (IM deltoid) on days 0 and 3 only

Do NOT give HRIG

Answer 16

Protocol for those exposed to rabies IF PREVIOUSLY VACCINATED